Information Collection

PESP Memebership Application

IC 205686 under ICR 201302-2070-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2070-XXXX PESP Memebership Application	Form and Instruction
2070-XXXX PESP Membership Application ATTACHMENT G_2415.01_PESP Membership Application_EPA Form No 9600-02.docx www.epa.gov/pestwise/pesp/application_form.html	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2070-XXXX	PESP Membership Application	ATTACHMENT G_2415.01_PESP Membership Application_EPA Form No 9600-02.docx	http://www.epa.gov/pestwise/pesp/application_form.html	Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	8,035	8,035
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.